PayPath Payment Service Receipt 8/29/16, 10:24 PM

Thank you for using PayPath Payment Service!

A payment was processed and posted successfully to your Georgia Institute of Technology account. Please
print this page as your receipt and close this payment session. A confirmation email was sent to
bryce.leitner.roberts@gmail.com

Your credit card statement will reflect two transactions with the following information:

"PayPath Georgia Institute of Technology" $811.00

"PayPath Service Fee" $22.30

Receipt Information

Payment to Georgia Institute of Technology: $811.00

PayPath Payment Service Fee:: $22.30
Total payment amount: $833.30

School name: Georgia Institute of Technology

Payer name: Bryce L Roberts
Billing address: 2183 Deep Woods Way
Billing city: Marietta
Billing state: GA
Billing postal code: 30062
Email address: bryce.leitner.roberts@gmail.com
Phone number: Not supplied
Card: MasterCard
Card number: xxxxxxxxxxxx4758
Date and time: 08/29/2016 09:24 PM
Browser internet address: 50.246.9.25
Reference number: 20160829000597
901645869 receipt ID: 2543640

The following accounts will receive the corresponding credit.

Student Id Amount
901645869 - Payments $811.00

Georgia Institute of Technology Contact Information

If you have any questions concerning this transaction, please contact Georgia Institute of Technology at:

Contact phone: 404 894 4618

Contact email: bursar.ask@business.gatech.edu

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Terms and Conditions

I hereby authorize charges totaling $833.30 via my credit card. I understand that a PayPath Payment
Service fee of $22.30 will be charged to my credit card and is not refundable under any circumstances.

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Contact Information | Phone: 404 894 4618 | Contact email: bursar.ask@business.gatech.edu

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